H1N1 vaccine here in late October

While the standard inoculation for flu is a shot, the first medicines to arrive for the novel H1N1 flu will be nasal sprays that use a live virus. These will be provided to only those at the highest risk.

By RICHARD SHAWSun Advocate publisher

The H1N1 virus has been studied in the southern hemisphere all summer and evaluated in the northern hemisphere since last spring. Now it is about to make another splash as fall turns into winter - the standard flu season in the United States and the state of Utah.

The H1N1 virus, at times, has been unpredictable. Yet it isn't really that much more serious for the average person than the regular seasonal flu that comes around each year. But the hype surrounding it has been tremendous. At times, the hype has been more of a problem than the malady itself.

"Initially, last spring it got too much attention (for what it was)," said Dr. David Sundwall, of the Utah State Department of Health, in a press conference Tuesday morning. "It was certainly newsworthy, but it caused too much fear."

Sundwall told the press that state and local health departments need their help this year to prevent illness and decrease the possibilities of death during the coming flu season.

"We clearly can't do this alone," he said. "What we need you to do is to dispel the wrong information and report the correct facts. We need to do away with the conspiracy theories and misinformation."

Last spring, many people panicked and clogged emergency rooms as they feared the new "novel" flu would kill them. Doctor's offices were jammed and people were reporting all kinds of symptoms. Yet, for most of them, just staying home, taking care of themselves and using community distancing (staying away from people while they were sick) would have solved a lot of problems.

Officials fear that same phenomenon will occur this season, too. However, they have a new tool in their back pockets that should help when the flu arrives. A vaccination package that appears to be effective has been developed by researchers. It will soon be available for at-risk people. And, just to dispel one of the conspiracy theories, Sundwall made a point.

"This vaccine will be completely voluntary," he said. "If a person decides not to be vaccinated, there will be no consequences."

The new vaccine that will only be effective against the novel H1N1 virus will arrive in the area sometime in mid- to- late October. That is good timing, since the height of the normal flu season is in January. It takes about three months for the vaccine to build up immunity in people. Yet rumors still persist that the vaccine could be dangerous to people.

"I have full faith that this vaccine is safe," said Dave Cunningham, director of the Southeastern Utah Health Department, following the closed circuit press conference from Salt Lake. "They have done a lot of work and testing on it. These companies that are providing it know their reputation is on the line and what happens could affect their future business."

The vaccine, which was assembled following research this summer, will be different from the seasonal vaccine that the SUHD presently provides for regular seasonal flu. Depending on age and health, it will be not only applied differently, it will also only be available for some people initially.

The first vaccine will come in the form of a nasal spray. This is called a live vaccine. It will be provided to some in the high-risk population. Shots will arrive not long after the nasal spray. For children nine years old and younger, two injections will be required. For those over age 10, one will suffice.

"There will be changes in the processes we use as the inoculations arrive and we start to use them," said Gary Edwards of the Salt Lake Valley Health Department.

Initially, there will be 45 million doses spread throughout the United States, with Utah getting about one percent of that amount. By December, the 195 million doses the federal government has ordered will be available. Each state is developing or has developed a delivery plan. According to Cunningham, Utah has been developing plans for this and other types of epidemics for years. He says they are ready.

"We have set up systems and practiced for this," he said. "In fact if this is no worse than the seasonal flu, it will be good practice for possibly worse scenarios that could come sometime in the future."

Initially, the vaccine will be provided to pregnant women, people who live with or care for children younger than six months of age, health care and emergency medical services personnel with direct patient contact, people from six months to 25 years of age, and people 25 to 64 years old who have health conditions associated with higher risk of medical problems from influenza. Once those groups are vaccinated, vaccination can begin for everyone from age 25 through 64. Studies show that people older than 64 are at much less risk than those below 64.

But there is much more involved in preventing the disease from spreading than just getting a shot. There will be plenty of people that will not get the inoculation, so standard hygiene practices should be followed such as washing hands regularly, covering the nose or mouth when sneezing or coughing and staying home from work or school if one does get sick. And if one does get sick, antiviral drugs can make things less severe.

There will be people who get sick from the H1N1 flu. But, as Edwards put it during the press conference, people need to use common sense when going to the doctor.

"Not everyone who is sick needs to be seen (by a doctor or a medical professional)," he said. "As for testing to see if people have it, that will depend on a number of things. But it isn't always necessary."

Scott Williams, of Mountain Star Healthcare, which owns a chain of hospitals along the Wasatch Front, said that often people make the flu worse just by some of the things they do.

"They need to seek care at the appropriate places at the appropriate times," he said. "And when someone is admitted to the hospital for the flu it seems people want to have a big family gathering in the room. They want to load up the car and go see grandma down at the hospital. That is not a good thing; there should only be a few people that come and go, mostly caregivers. People should avoid tagalongs, especially children under 12 years of age."

The SUHD will let the word out through a number of sources when the H1N1 vaccine arrives in the area. They will also release information on the handling of inoculations at the same time.